Abstract Body:
Purpose The aim of this review is to summarize physical activity interventions in rural women in the United States using the socio-ecological model of health framework.
Methods We conducted a scoping review of peer-reviewed literature in Medline, CINAHL Complete, Web of Science, and PsychINFO in August 2023. We narratively synthesized the evidence and, in studies with a comparison group, calculated pooled estimates to compare intervention effects by levels of the socio-ecological model. We used an adapted GRADE approach to assess study quality.
Findings Our search yielded 41 reports of 38 different interventions that met our eligibility criteria (24 individual and 17 multi-level). Nineteen individual (83%) and eight multi-level (73%) interventions increased physical activity. Pooled estimates indicated that multi-level interventions increased physical activity to a greater extent (1.09 [-0.44, 2.16]) than individual-level interventions (0.18 [-0.26, 0.62]). Limited studies included measurements of feasibility, acceptability, strengths, and barriers or clearly defined rurality. Special considerations for intervention design included ensuring that participants feel supported, training and supporting strong interventionists using new technology, and assessing cost-effectiveness.
Conclusion Our findings suggest individual-level interventions often increased physical activity in rural women, but multi-level interventions yielded larger effects. More high-quality, multi-level interventions that track key implementation factors (feasibility, acceptability, strengths, barriers) and define rurality are needed
Figure 2. Individual vs. Multi-level Intervention Effects.